Obtaining a dental degree and a license to practice dentistry are recognized as great achievements. However, the transition from undergraduate student to independent clinical practitioner is considered a major challenge, especially initially. Most new graduate dentists faced common challenges, including a higher level of responsibility when treating patients compared to the undergraduate level. At the same time, new graduates are supposed to be learning and grasping new information during this process. Some studies report that it requires several years of clinical practice to develop skills and knowledge. Meanwhile, a limited number of studies offer qualitative research on dental interns’ learning experiences.
In this study, we evaluated interns’ perceptions of their training experience from different aspects, mainly the work environment and level of supervision. The method used to evaluate interns’ perceptions was a 20-item questionnaire, which was mailed to interns with instructions to complete and submit it at the end of each rotation. Submitted questionnaires were to be read only by the interns’ affair unit, allowing interns to provide honest answers without being influenced. The questionnaires are based on a Likert-type format, a commonly used method in dentistry to explore students’ and graduates’ perceptions of their education (22, 23). Other methods used for this purpose include interviews (17), anecdotal evidence (24), and close-ended questionnaires (25). Manague et al. reported that most evaluation tools in dental school are mainly based on daily observations and exams (26). A low response rate is believed to be one limitation of questionnaire-based methods (27). In this study, however, participants were informed that filling out and submitting questionnaires was a requirement; as a result, all participants submitted completed questionnaires.
In this evaluation, interns were very satisfied with their training experiences and supervisors. The assumption that male interns would rank preparedness higher than female interns was not evident in this study as both genders gave similar responses. Nearly all evaluated areas were deemed excellently covered by the training centers. The fact that interns were able to choose their training center and research area of interest provided them great satisfaction from the start, facilitating their training experience and reducing the risk of conflicts.
Meanwhile, interns’ satisfaction regarding the work required of them may be based on the fact that they were not asked to complete a certain number or type of clinical cases. In fact, most training centers only assigned walk-in patients or patients presenting to the clinic for pain treatment. Most patients requiring advanced treatment that can involve several visits were treated in specialists’ clinics. Thus, the majority of interns’ clinical work involved first stages of treatment, such as pulp extirpation or tooth extraction. This differs from undergraduate training where they are required to complete a certain number and type of dental cases as they need approval and evaluation during each step. In addition, assessment criteria at the end of each training rotation are based mainly on interns’ attitudes and their integration with staff. All these findings were somewhat similar to those reported in other studies regarding dental students’ and graduates’ perceptions of their learning experiences during undergraduate and postgraduate periods (28, 29).
The high satisfaction reported by interns may be attributed to the fact that all training centers are government institutes, which typically have good facilities and supplies, as well as a high number of clinics and staff members. Thus, this may help establish good training programs for interns, focusing more on skill improvement than requirements. The training experience is believed to be somewhat similar across different centers since the internship program is standardized for dental interns. As such, all interns are asked to be observers at the clinic, or mainly perform first stage dental treatments such as operative or endodontic therapy. Interns may be allowed to treat more advanced cases if they have demonstrated sufficient ability and ask to lead such cases.
Regarding supervision, it has been noted that the role of clinical supervisor in interns’ learning experience has a greater influence in the clinic compared to classroom settings (30). To ensure an effective learning experience for interns, the clinical instructor or supervisor should exhibit theoretical and clinical knowledge while engaging trainees as a teacher (2, 28). In this study, interns reported that clinical supervisors were always present. This may be due to the high number of available supervisors who, in general, are qualified and experienced, thereby enabling close relationships between interns and supervisors (16). This relationship allows more time for interns to improve their clinical and research skills. Such improvement may be the main factor for interns’ high satisfaction, along with not having specific requirements for completing their internship.
The interns seemed satisfied with the cooperation they received from supervisors. This is important since conducting research projects may be a goal for interns seeking to improve their resumes for future job applications or postgraduate programs (16). The interns’ daily work with supervisors at the training center may help facilitate research work. Several studies revealed the importance of supervisor characteristics, such as availability, encouragement, and providing feedback to trainees. Moreover, there appeared to be no issues regarding deficiencies in dental materials and equipment. This may be of great importance to interns since it allows a smooth training experience. In addition, introducing interns to modern technology will teach them the latest updates in the field (2). Completing training at institutes with such facilities may ensure high satisfaction levels, as reported in this survey.
While this survey contained 20 items, it was mainly designed to determine if interns believed their training experience improved their ability to think, solve problems, and develop skills as a team member. Such improvements are a main outcome expected from the internship year and may facilitate the transition to practice. Thus, receiving interns’ feedback is essential to evaluate this outcome. Along with intern questionnaires, supervisors had a form to evaluate interns, allowing us to obtain feedback from all parties involved in the training process.
Constructive feedback is believed to be an assistive tool for an effective learning experience. Interns revealed that encouragement was beneficial for communication with supervisors and enabled a stronger commitment to learn (13, 31). Also, while many interns reported that critical feedback is important in developing clinical skills, it should be delivered in a respectful manner to avoid causing embarrassment, particularly in the presence of patients or other interns.